The effect of discontinuation of antihypertensives on the risk of acute myocardial infarction and stroke

Abstract

The results of this study show that in daily clinical practice early discontinuation of antihypertensive drug treatment in primary prevention increases the risk of subsequent AMI or stroke.

Heterogeneity in antihypertensive treatment discontinuation between drugs belonging to the same class

“…That is, that discontinuation is less evident for the initial prescription of an angiotensin receptor antagonist or an angiotensin-converting enzyme (ACE) inhibitor than for the initial prescription of a diuretic or a b-blocker [1][2][3][5][6][7][8][9]15]. Because treatment discontinuation leads to increased cardiovascular risk [16][17][18][19][20][21], this has been used for the calculation of actual cost of treatment in relation to its expected benefits when different drug classes are employed [22,23].…”

Modelling the costs of care of hypertension in patients with metabolic syndrome and its consequences, in Germany, Spain and Italy

“…For the proportion of the population who were treated, these risks were adjusted to take into account the impact of treatment on incident cardiovascular disease (CVD) events. Risk multipliers of 0.87 were used for acute myocardial infarction, congestive heart failure and unstable angina, and 0.78 and 0.83 for stroke and death, respectively [43][44][45][46] Annual prevalence estimates were multiplied by a country-specific mean annual cost that included resource use associated with the management of diabetes and the cost of non-CVD related complications. The source used for these costs provided an annual cost per patient for the treatment of diabetes and its complications, which did include CVD-related events [49].…”

“…Untreated risks were risk group-and cardiovascular endpoint-specific. Both untreated and treatment-related risk multipliers were derived from the literature [7,9,[42][43][44][45][46] ( Table 2). The main publications used for deriving cardiovascular risk were European, based on patients with hypertension and MetS and provided a breakdown of risk by number of MetS components.…”

Carga epidemiológica y económica de la hipertensión arterial en pacientes con síndrome metabólico en España: un modelo basado en la prevalencia

“…Sus riesgos relativos en la población no tratada se aplicaron a todos los grupos de riesgo y, se ajustaron en la población tratada según el impacto del tratamiento sobre los episodios CV incidentes. Los factores de multiplicación de riesgo relacionados con el tratamiento o la ausencia de tratamiento también se calcularon 11,[41][42][43][44][45][46] .…”